How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Facility | None | $81.28 | $81.28 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $77.62 Typical High $109.65 | Facility | None | $64.57 | $77.62 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $128.82 | Professional | None | $91.20 | $109.65 | $128.82 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $144.54 Typical High $1,174.90 | Facility | None | $85.11 | $144.54 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $562.34 Typical High $794.33 | Professional | None | $93.33 | $562.34 | $794.33 |
United Setting Facility Modifier None Typical Low $89.13 Median $602.56 Typical High $1,380.38 | Facility | None | $89.13 | $602.56 | $1,380.38 |
United Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $128.82 | Professional | None | $67.61 | $91.20 | $128.82 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $54.95 | Professional | 52 · Reduced service | $40.74 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $21.88 | Professional | 53 · Discontinued | $16.22 | $16.22 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $10.96 |
Where Oklahoma sits
The same service costs 3.8 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oklahoma· 26th of 51
$115
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.